Will New Cholera Initiative Treat the Epidemic as an Emergency?

Wednesday, 12 December 2012 14:52

As expected, the U.N. launched a new cholera eradication initiative yesterday at a press event in the late afternoon featuring U.N. Secretary General Ban Ki-moon and other speakers. The Miami Herald’s Jacqueline Charles leads off her article on the announcement by noting the U.N.’s own relatively small contribution toward funding the $2.2 billion plan (which also calls for an additional $70 million for the Dominican Republic):

The United Nations will provide support and $23.5 million in funding to help Haiti and the neighboring Dominican Republic eliminate a deadly cholera epidemic that has sickened more than 600,000 and killed more than 7,700, U.N. Secretary General Ban Ki-moon said Tuesday.

…

In addition to the U.N.’s contribution, Ban said donors will provide $215 million. But the money still falls short of the $600 million Haitian Prime Minister Laurent Lamothe said is needed to implement the plan over the next two years focusing on improving water and sanitation services.

Ban promised to "use every opportunity" in the next months to advocate for more funding for the plan.

"We know the elimination of cholera is possible. Science tells us it can be done," Ban said. "It can and will happen in Haiti."

Ban also announced he was enlisting Partners in Health founder Paul Farmer as a “Special Advisor” who will help raise funds for the initiative, including from “governments, multilateral organizations, the private sector and individual philanthropists.”

Several other key players from the plan’s partners were present at yesterday’s press event, including Dominican president Danilo Medina, Haitian Prime Minister Laurent Lamothe, and representatives of the Pan American Health Organization (PAHO) and UNICEF. As AFP reported:

Haitian Prime Minister Laurent Lamothe backed the UN campaign to "put an end to this terrible disease" and also did not mention the cause. "We want to reaffirm the political will of the Haitian government to do whatever it takes to eradicate cholera in the country," he said at a ceremony with Ban.

Reuters reports Ban as saying, "Haiti has seen a dramatic fall in infection and fatality rates. But this will not be a short-term crisis. Eliminating cholera from Haiti will continue to require the full cooperation and support of the international community.”

It hasn’t been a “short-term crisis” so far, unfortunately, but that does not mean that the international community should not respond as urgently as possible in order to prevent new infections and deaths. But the plan includes what appear to be modest benchmarks. Regarding the crucial areas of water and sanitation infrastructure, for example, in the first years 2013 – 2015, the plan aims to achieve an “Accelerated rate of construction of semi-collective sewer systems and treatment wastewater plants” and “Accelerated rate of access to latrines, septic tanks, and sludge removal operations” in just “3 of 25 cities” among other goals.

As CEPR Co-Director Mark Weisbrot notes in an op-ed for Aljazeera today, the announcement of the initiative comes more than two years after the cholera outbreak began – two years that have been marked by international pressure on the U.N. to do something about the disaster it created. Protesters in Haiti, grassroots criticism, a lawsuit on behalf of cholera victims filed by the Institute for Justice and Democracy in Haiti, a letter from 104 members of Congress, and editorials and op-eds in newspapers such as the New York Times, the Boston Globe, the Guardian of London and the London Independent have all been part of an international campaign calling on the U.N. to take responsibility. The award-winning film “Baseball in the Time of Cholera” has helped to raise awareness of U.N. culpability for causing the epidemic, and a new online petition hosted by Avaaz.org (and launched by Oliver Stone) urging the U.N. to take responsibility has gathered thousands of signatures so far in just six days.

…would not comment on whether the U.N. peacekeeping mission is to blame for bringing cholera to Haiti. Scientific studies have suggested that U.N. peacekeepers from Nepal inadvertently introduced the disease, and protests erupted in Haiti amid reports of sanitation problems at a base that was housing the troops.

That issue "is with the legal office and as a staff member I am not authorized to say anything about the legal process at this time," Fisher said. "My focus is on today, as it has been since the outbreak, and is on making sure that Haitians stay alive."

Fisher and PAHO Director Mirta Roses Periago were asked about what measures the U.N. was putting in place to ensure that U.N. personnel avoid causing such an outbreak again in the future. Periago’s response was less than reassuring. As the AP reports:

Mirta Roses Periago, the director of the Pan American Health Organization, said it is not necessarily advisable to screen every peacekeeper for diseases before they are deployed. But she said PAHO has advised the secretary-general "to have special provisions for people coming from endemic areas and being sure that there is no outbreak going on at the time that people are being deployed."

As the AP notes, “The U.N. has already spent $118 million on responding to the cholera epidemic in Haiti.” Along with the $23.5 that the U.N. announced it would contribute yesterday, this still is only just 21 percent of MINUSTAH’s budget for the current fiscal year ($676 million). This is why we have suggested that the MINUSTAH budget be put instead toward fighting cholera: “The U.N. troops have no reason for being in Haiti,” [Weisbrot] said. “There is no conflict there. The Mission’s $676 million budget should be spent instead on eliminating cholera.”

Haiti’s president Michel Martelly expressed similar sentiments earlier this week during a trip to South Florida, as the Miami Heraldreported:

In the strongest statement by any Haitian leader since the disease arrived in Haiti, 10 months after the quake, Martelly said Monday that while he won't engage in the debate about who's responsible for cholera in Haiti, the Untied Nations "certainly" should take responsibility.

"The U.N. knows better than me who has brought cholera to Haiti," he said. "The U.N. itself could bring money to the table."

UPDATE, 4:22 PM:

A statement [PDF] on the initiative was released today under the auspices of the Haiti Advocacy Working Group, signed by a dozen organizations including American Jewish World Service, the Episcopal Church, Church World Service, Oxfam America, TransAfrica, and others.

It reads, in part:

This, however, is only the beginning. Without long-term funding and leadership, the vision of this plan will not be realized. We call on all donors from across the world to commit to this project now. Support for the development of basic infrastructure and a strong health system will help the Haitian government protect and promote the universal right to the highest attainable standard of health and prevent the spread of other water-borne diseases.

Successful implementation will require working closely with civil society organizations and local communities. These projects must be done in concert with those who will benefit, particularly women who are overwhelmingly responsible for providing water for their families. These projects must also be designed to ensure that they will remain sustainable long after international attention and funding ends.

The signers also state: "We will be monitoring progress to ensure the plan is fully-funded and benefits the most marginalized populations.”